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Article

Spinal Cord Stimulation Prevents Autonomic Dysreflexia in Individuals with Spinal Cord Injury: A Case Series

by
Soshi Samejima
1,2,
Claire Shackleton
1,2,
Raza N. Malik
1,2,
Kawami Cao
1,2,
Anibal Bohorquez
2,3,
Tom E. Nightingale
1,4,5,
Rahul Sachdeva
1,2 and
Andrei V. Krassioukov
1,2,3,*
1
International Collaboration on Repair Discoveries, Faculty of Medicine, University of British Columbia, Vancouver, BC V5Z 1M9, Canada
2
Division of Physical Medicine and Rehabilitation, Department of Medicine, University of British Columbia, Vancouver, BC V5Z 2G9, Canada
3
Spinal Cord Program, GF Strong Rehabilitation Centre, Vancouver Coastal Health, Vancouver, BC V5Z 2G9, Canada
4
School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
5
Centre for Trauma Sciences Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2023, 12(8), 2897; https://doi.org/10.3390/jcm12082897
Submission received: 3 March 2023 / Revised: 4 April 2023 / Accepted: 12 April 2023 / Published: 16 April 2023
(This article belongs to the Special Issue Spinal Cord Injuries: Advances in Rehabilitation)
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Abstract

Spinal cord injury (SCI) results in severe cardiovascular dysfunction due to the disruption of supraspinal control. Autonomic dysreflexia (AD), an uncontrolled rise in blood pressure in response to peripheral stimuli including common bowel routine, digital anorectal stimulation (DARS), reduces the quality of life, and increases morbidity and mortality. Recently, spinal cord stimulation (SCS) has emerged as a potential intervention to mitigate unstable blood pressure following SCI. The objective of this case series was to test the real-time effect of epidural SCS (eSCS) at the lumbosacral spinal cord, the most common implant location, on mitigating AD in individuals with SCI. We recruited three individuals with cervical and upper thoracic motor-complete SCI who have an implanted epidural stimulator. We demonstrated that eSCS can reduce the elevation in blood pressure and prevent DARS-induced AD. The blood pressure variability analysis indicated that eSCS potentially reduced vascular sympathetic nervous system activity during DARS, compared to without eSCS. This case series provides evidence to support the use of eSCS to prevent AD episodes during routine bowel procedures, improving the quality of life for individuals with SCI and potentially reducing cardiovascular risks.
Keywords: spinal cord injury; spinal cord stimulation; autonomic dysreflexia; cardiovascular function; epidural stimulation spinal cord injury; spinal cord stimulation; autonomic dysreflexia; cardiovascular function; epidural stimulation

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MDPI and ACS Style

Samejima, S.; Shackleton, C.; Malik, R.N.; Cao, K.; Bohorquez, A.; Nightingale, T.E.; Sachdeva, R.; Krassioukov, A.V. Spinal Cord Stimulation Prevents Autonomic Dysreflexia in Individuals with Spinal Cord Injury: A Case Series. J. Clin. Med. 2023, 12, 2897. https://doi.org/10.3390/jcm12082897

AMA Style

Samejima S, Shackleton C, Malik RN, Cao K, Bohorquez A, Nightingale TE, Sachdeva R, Krassioukov AV. Spinal Cord Stimulation Prevents Autonomic Dysreflexia in Individuals with Spinal Cord Injury: A Case Series. Journal of Clinical Medicine. 2023; 12(8):2897. https://doi.org/10.3390/jcm12082897

Chicago/Turabian Style

Samejima, Soshi, Claire Shackleton, Raza N. Malik, Kawami Cao, Anibal Bohorquez, Tom E. Nightingale, Rahul Sachdeva, and Andrei V. Krassioukov. 2023. "Spinal Cord Stimulation Prevents Autonomic Dysreflexia in Individuals with Spinal Cord Injury: A Case Series" Journal of Clinical Medicine 12, no. 8: 2897. https://doi.org/10.3390/jcm12082897

APA Style

Samejima, S., Shackleton, C., Malik, R. N., Cao, K., Bohorquez, A., Nightingale, T. E., Sachdeva, R., & Krassioukov, A. V. (2023). Spinal Cord Stimulation Prevents Autonomic Dysreflexia in Individuals with Spinal Cord Injury: A Case Series. Journal of Clinical Medicine, 12(8), 2897. https://doi.org/10.3390/jcm12082897

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